02. Attachment theory and research

Key Messages

Topic 2: Attachment theory and research

Children need a relationship with a caregiver who is sensitive and responsive, who comforts the child when distressed and enables them to feel safe enough to relax, play and learn. This is the basis of a secure attachment.

Attachments are formed during the first year of life even in the context of maltreatment. However, such attachments are more likely to be disorganised.

Developing a secure attachment with a substitute carer is key to improving outcomes for these children. The emotional and behavioural strategies children use to protect themselves, however, puts them at risk of being rejected by others and can affect all relationships.

Children who are securely attached have higher self-esteem and empathy, and can deal with stress more effectively.

What is attachment?

Babies are born with a biological drive to seek proximity to a protective adult for survival. They are dependent on the physical and emotional availability of the key adults who take care of them. Their relationships with adults are crucial to their trust of other people, their understanding of relationships generally and their feelings about themselves (Simmonds, 2004). The drive for closeness promotes attachment behaviours, which helps children feel safe.

Attachment theory draws on the work of John Bowlby and Mary Ainsworth (see Shemmings, 2011). Attachment refers to the special bond and the lasting relationships that young children form with one or more adults. It refers specifically to the child’s sense of security and safety when in the company of a particular adult (Wittmer, 2011).

How are attachments formed in infancy and beyond?

An infant’s attachment behaviours can attract the caregiver’s attention in a positive way (e.g. cooing, smiling and reaching out), as well as in the form of protest behaviours (e.g. crying and fretting). All these behaviours give strong signals, which lead caregivers to approach and respond to the needs of the baby. The adults who respond to these attachment behaviours become highly significant and, as a result, selective attachments begin to form from birth and early infancy (Schofield and Beek, 2006).

A physically and emotionally available mother spends a lot of time cuddling and gazing at her baby, who responds by snuggling, babbling and smiling. This creates a reciprocal positive feedback loop of pleasure and satisfaction – the ‘maternal-infant dance’ – from which attachment develops (Schofield and Beek, 2014; Perry, 2001). And when the baby feels discomfort and cries, the caregiver is there to tend to their needs in a nurturing manner.

The following video provides an example of this ‘maternal-infant dance’ (also known as ‘serve and return’) and the baby’s distress when her mother does not respond to her.

The development of attachment relationships continues throughout childhood:

Toddlers – mobility, play and language development provide opportunities to extend attachment relationships to siblings and close adults.

Pre-school and primary years – securely attached children can think about others’ feelings and manage relationships with their peers. They can manage their feelings and co-operate with others (Schofield and Beek, 2006).

Attachment security is also important in adolescence. Securely attached adolescents are less likely to engage in excessive drinking, drug use and risky sexual behaviours. They are also likely to have fewer mental health problems. Adolescents benefit from parenting that encourages autonomy but also offers warmth, behaviour monitoring, limit setting and negotiation of rules and responsibilities (Moretti and Peled, 2004).

Children can form multiple attachments and can also form new attachments at any age. Fostered and adopted children need to learn to trust their new primary caregivers and to develop attachments to them (Schofield and Beek, 2009).

Types of attachment patterns

Much of what we know about attachment comes from research by Mary Ainsworth using the Strange Situation Procedure (see Shemmings, 2011).

The most important distinction is between secureand insecureattachment. (Insecure and disorganised attachment patterns are common; they are found in around 45% of the population.) There are different patterns of insecure attachment, related to the type of caregiving received. These patterns of attachment are indicative of a child adapting to their relationship with their attachment figure (Simmonds, 2004) and are summarised below:

Secure attachment (55% of the population) occurs when the child is cared for by sensitive and responsive caregivers. Securely attached children are able to regulate their distress and know they can show their needs and feelings and won’t be rejected.

Insecure avoidant attachment (23% of the population) tends to occur when the caregiver finds it difficult to accept or respond sensitively to the infant’s needs. These children tend to experience parenting that is hostile, rejecting and controlling. They come to see themselves as neither loved nor loveable. Children respond to this by shutting down on their feelings because of their anxiety that any display of need or emotion may drive their caregiver away.

Insecure ambivalent attachment (8% of the population) tends to occur when the caregiver responds inconsistently to the child’s demands. These children exaggerate their attachment behaviour to attract attention. They are not always successful at being noticed and their ambivalence reflects their simultaneous need for and anger with their attachment figure.

Disorganised attachment (15% of the population) may occur in children who are cared for by people who are frightening. Children may fear approaching their caregiver because they cannot predict whether they will respond positively (e.g. with cuddles) or negatively (e.g. shouting, smacking). Consequently these children are not able to ‘organise’ their own behaviour and have difficulty regulating their emotions. Although only around 15 per cent of children develop this attachment style, up to 80 per cent of children who are maltreated develop disorganised attachments. Not all children who have disorganised attachment will have been maltreated, however (e.g. children on the autism spectrum).

(Shemmings, 2011; Brown and Ward, 2013)

Older children are likely to display disorganised attachment by gaining control, either through excessive role-reversed caregiving to the adult or by becoming hostile and punitive (Shemmings, 2011).

The importance of secure attachment

Young children who have sensitive and responsive attachment figures develop trust. This allows them to explore their world while knowing that if they need help, they can return to their ‘secure base’ (i.e. attachment figures they can turn to as a safe haven when upset or anxious) (Schofield and Beek, 2014).

Further information on providing a secure base can be found here: The Secure Base Model (Schofield and Beek)

Early attachment is important because it acts as an ‘internal working model’ (or template) for subsequent relationships. This model refers to a set of expectations and beliefs about the self and others. For example, a baby whose crying results in a prompt response will learn that certain of his behaviours are linked with the positive behaviours of his caregiver, and he will feel that he is loved and nurtured. A response that is unavailable or cold will lead to an internal working model of the attachment figure as rejecting, the self as unworthy of care and others as not to be relied on for help and support (Schofield and Beek, 2014).

Children’s expectations of themselves and others also influence the ways in which other people relate to them. A young person who expects rejection and has low self-esteem is likely to signal to other people that they should not come close, which is likely to lead to further rejection. Sensitive caregiving is needed in this situation to overcome children’s hostility and lack of trust (Schofield and Beek, 2014).

Children who are securely attached benefit in a number of ways:

they have higher self-esteem and empathy

they can deal with stress more effectively

they have faster memory recall

they have higher impulse control

they are reliable and likely to be popular with others (Shemmings, 2011).

Maltreatment and attachment

Attachments are formed during the first year of life, even in the context of maltreatment, although these attachments may be disorganised. The infant seeks comfort from a caregiver who is also the source of fear. As a result, they remain in a state of high anxiety, which can have an impact on brain development (Schofield and Simmonds, 2011). (see also the briefing on ‘Early brain development and maltreatment’)

Maltreated children are likely to have negative expectations of adults and will transfer these expectations and patterns of defensive behaviour into new environments (e.g. foster or adoptive families). These children may find it hard to let adults come close enough to establish trusting relationships. However, caregiving that is warm, consistent and reliable can change the children’s previous expectations of close adults and of themselves (Schofield and Beek, 2014).

The attachment style of the adult who provides substitute care for the child is also an important consideration. Carers need to be skilled at helping children to manage very strong feelings and need to be in touch with their own feelings.

Contact and attachment

Young children who are removed from harm and provided with secure caregiving are able to form an attachment to their new carer. However, this attachment can be compromised if contact with the child’s birth family is not sensitively handled (Schofield and Simmonds, 2011).

Infants who have frequent contact with their birth family may suffer constant disruption to their daily routines and may be unable to experience the kinds of settled caregiving they need to help repair the harm they have experienced. Such contact arrangements can produce high levels of stress for the infant through discontinuity of care and potentially insensitive care during contact. It can then be a challenge for carers to help the infant to relax and trust them, and may compromise the child’s development.

What is your understanding of the impact of separation on infants, children and young people?

What steps do you take to achieve quick and decisive action when it is in the child’s best interest to be placed away from home?

See Brown and Ward (2012) for a review of the evidence on decision-making within a child’s timescale, including a summary of key timeframes for child development on page 46

What steps do you take to ensure a thorough assessment of the child?

How to do you ensure that children are placed with a foster carer or adopter who can best meet their individual needs?

How do you plan placement moves and avoid the need for multiple placements and separations?

How do you demonstrate to children that you care?

What support do you provide for contact visits and the emotional challenges that may follow contact?

What do you do to help you actively seek the views of the child’s foster carer or adopter, and how do you facilitate appropriate support and interventions to address the child’s needs?

Key questions for the supervising social worker

Methods
Suitable for self–directed learning

Learning Outcome
Review current provision and identify actions that can enhance the support provided to foster carers and adopters

Time Required
Three sessions of 45 minutes

Process

Read the questions in the following list and assess what actions you take at the moment and what additional support you could provide.

You may find it useful to focus on three or four questions at a time.

What actions can you take to ensure that the adults involved in providing alternative care for the child are properly prepared? This includes prepared to take on the care of a maltreated child in general, but also prepared to care for this child in particular –need for accurate information, time with foster carer, good understanding of reasons for decisions etc.

How do you help foster carers and adopters understand children’s needs for contact when they move placement?

How do you help foster carers and adopters to understand and respond to children’s behaviour?

How can you signpost and facilitate access to support and specialist interventions to help foster carers and adopters understand and respond to the child’s behaviour, taking into account the child’s attachment history and their experience of abuse, neglect, separation and loss?

What actions can you take to encourage and support foster carers (and adopters) to access specialist learning and development opportunities?

How do you keep in close contact with foster carers and adopters to support them throughout the placement including listening when they talk about their own experiences?

Are there safe places for carers to express negative emotions and ambivalence about the children they care for?

How easy is it for carers to access support in the evenings and at weekends?

What actions can you take to provide adequate support for contact visits and the emotional challenges that may follow these?

To what extent do the adoption plans that are agreed by the court locally focus on the child’s needs?

How can you work with case-holding social workers to share knowledge of research and best practice around contact in long term care?

How can you work with case holding social workers to ensure that you and the carers you work with have all the necessary information about a child available to ensure that the right kind of care is provided?

How do you balance the need to work in partnership with foster carers as fellow colleagues alongside your role in protecting the child in placement?

How do you support adopters to claim children and take responsibility for them whilst still focussing on the child’s needs and vulnerabilities during the early stages of placement?

How do you ensure that you observe and listen to children’s non-verbal communication when they move placements?

Key questions for foster carers and adoptive parents

MethodsSuitable for a small group discussion.

Learning OutcomeTo identify a range of actions that can support a child to develop healthy attachments.

Time Required45 minutes discussion and 15 minutes feedback

ProcessAsk the group to discuss the following questions and appoint a person who can feedback their ideas.

Why are the links between a child’s behaviour, emotions, development and their attachment relationships important?

How can we understand a child’s intense feelings towards their attachment figures even when they have been abused or neglected?

How can we try to make sense of a child’s wishes and feelings feels and find ways of responding to this?

What methods (e.g. photographs, toys, play and discussion) can we use to help a child remember the people who are or were important?

How can we give a child a consistent daily routine to provide security and predictability?

How can you find and undertake specialist learning and development opportunities?

How can you manage contact visits and the separation once the contact visit is over?